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S433
S433 – Sacrococcygeal teratoma
OHIP Urology Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
S433A is the fee for the surgical excision of a sacrococcygeal teratoma. This procedure is listed under the Extra Renal Procedures subsection of the Urogenital and Urinary Surgical Procedures section of the Schedule. Payment for surgical assistant (S433B) and anaesthetist (S433C) are based on 6 base units each plus time units as defined in the General Preamble (, ).
When to Use
- Use S433A for the definitive surgical excision of a sacrococcygeal teratoma in neonates or infants.
- Use this code when the procedure is performed as a standalone surgical intervention, distinct from other urogenital procedures like S431 or S432.
Common Pitfalls
- Failure to apply the mandatory age-based premium (e.g., AGE_PREMIUM_LT30D) for neonates, which is a common oversight that results in significant underpayment.
- Attempting to bill S433A alongside other urogenital surgical codes without clear documentation of separate incisions or distinct anatomical sites, which risks rejection for unbundling.
Billing Tips
- Ensure the surgical assistant (S433B) and anaesthetist (S433C) claims explicitly reference the base units and time units as per GP85 and GP92 to avoid manual review delays.
- If the procedure is performed on an emergency basis, ensure the correct non-elective premium (E409A or E410A) is appended to the S433A claim to capture the 50-75% fee increase.
Provider Fee$437.20
Surgical Assistant Fee$75.06
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Category
T. Urogenital and Urinary Surgical Procedures
Subcategory
UROGENITAL AND URINARY SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Urogenital and Urinary Surgical Procedures
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